Examination of the structural components of the Abilitator-A self-report questionnaire on work ability and functioning aimed at the population in a weak labour market position.

OBJECTIVES: According to the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) panel, structural validity describes how well Patient-Reported Outcome Measures' (PROM) scores reflect the dimensions of the measured construct. The main purpose of this study was to examine the structural components of the Abilitator, a co-developed self-report questionnaire on work ability and functioning for the population in a weak labour market position. METHODS: We examined to what extent the Abilitator has reflective and formative elements in its five summary scales: "C. Inclusion", "D. Mind", "E. Everyday life", "F. Skills", and "G. Body". The Abilitator data sample (n = 4555, men 51%, mean age 37 years) was collected in 2017-2022 by the Finnish Institute of Occupational Health in cooperation with the European Social Fund Priority 5 projects in which the participants have multiple challenges to gain employment. For the structural components and validity analysis we implemented both Confirmatory Factor Analysis (CFA) and Exploratory Factor Analysis (EFA). RESULTS: Based on the COSMIN criteria for structural validity, the Abilitator reached approximate model fit with CFA when we analysed the different concepts of the questionnaire separately rather than in one unified model. An exception was "E. Everyday life" which was a formative summary scale, and it did not reach approximate fit. EFA showed that the items in the Abilitator's summary scales loaded on ten factors. CONCLUSIONS: The Abilitator had both reflective and formative elements in its structure. It reached structural validity in those separate concepts that were based on a reflective model. This study revealed interesting connections between different aspects of the Abilitator and produced valuable information for further modification of the questionnaire.

Associations between the Abilitator, a self-reported measurement tool of work ability and functioning, and national register-based indicators of health and employment.

OBJECTIVES: The Abilitator is a recently developed self-reported measurement tool for work ability and functioning of people in a weak labour market position. The aim of this study was to describe how self-reported information gathered with the Abilitator corresponds to information drawn from national registers. DESIGN, SETTING AND PARTICIPANTS: Participants (n=669, mean age 44 years, 55% women) took part in the Work Ability Programme (2020-2023) that provided services for unemployed people with reduced work ability. They filled in the Abilitator questionnaire at the start of the service. Register-based data on participants' health, income and received benefits was drawn from national registers. We evaluated how the different types of indicators concurred. RESULTS: Statistically significant correlations (from weak to moderate) were found between different domains of the Abilitator and register-based data. Also, participants' health status (information on mental health or musculoskeletal disorders) was displayed coherently in the results of the Abilitator. Overall, diagnosed mental health disorders distinguished participants' Abilitator responses more strongly than diagnosed musculoskeletal disorders. CONCLUSIONS: These findings provide further evidence on the applicability of the Abilitator as an instrument to evaluate work ability and functioning of people outside the work force.

Intrarater reliability of the Abilitator-a self-report questionnaire on work ability and functioning aimed at the population in a weak labour market position: a test-retest study.

OBJECTIVES: The Abilitator is a patient-reported outcome measure (PROM) of work ability and functioning of those in a weak labour market position. It covers items for work ability and self-rated health, for example, and summary scales for social, psychological, cognitive and physical functioning, as well as everyday skills. The aim of this study was to evaluate the intrarater test-retest reliability, internal consistency and basic psychometric properties of the Finnish version of the Abilitator. DESIGN, SETTING AND OUTCOME: The test-retest study was conducted in European Social Fund projects in 2018-2019. The participants completed two Abilitator questionnaires over 7-14 days. The internal consistency analysis was based on data collected in 2017-2019 in services for the long-term unemployed. The reliability was assessed using correlations (r, rs , intraclass correlation coefficient (ICC)), agreement with Bland-Altman analysis and internal consistency with Cronbach's alpha. PARTICIPANTS: The test-retest study had 67 participants (52% men, mean age 43.9 years) and the internal consistency study 10 923 (48% men, mean age 38.58 years), respectively. Of all the participants, 80% had been unemployed for over a year. RESULTS: The test-retest r or rs ranged from 0.71 to 0.93 and ICC from 0.74 to 0.93 for the items and summary scales. An exception was the life satisfaction item, with an rs of 0.60 and ICC of 0.45. A statistically significant difference was observed in the summary scale for social functioning (t=-2.01, p=0.049). Agreement was observed for all variables except social functioning. Alphas for summary scales ranged from 0.74 to 0.91. CONCLUSIONS: The Finnish version of the Abilitator is a reliable PROM for the target group and has acceptable to excellent intrarater test-retest reliability and internal consistency, apart from the life satisfaction item. Further testing is needed for the social functioning summary scale.

Correction to: Development and content validity of the Abilitator: a self-report questionnaire on work ability and functioning aimed at the population in a weak labour market position.

It was highlighted that the original article [1] contained an ambiguity in the citation of Reference 2 in the Results section.

Development and content validity of the Abilitator: a self-report questionnaire on work ability and functioning aimed at the population in a weak labour market position.

BACKGROUND: The unemployed have lower work ability and poorer health than the employed. This situation deteriorates when unemployment continues. The long-term unemployed often have co-morbidities and face many other challenges. This increases the need for a multidimensional assessment of work ability and functioning in different service settings. In this study, we describe the development and analyse the content validity of the Abilitator, a self-report questionnaire on work ability and functioning for those in a weak labour market position. METHODS: The Abilitator was developed in 2014-2017. Its construct was assessed by members of academic expert panels (n = 30), practical expert panels of professionals (n = 700) and target group clients (n = 28). The structure and the content of the questionnaire was co-developed in 29 workshops and adjusted twice based on the expert panels' feedback. The Abilitator was also implemented among target group clients (n = 3360) in different services and projects. During its development the Abilitator was linked to the International Classification of Functioning, Disability and Health (ICF). The content validation process followed the guidelines recommended by the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) panel. RESULTS: The construct of the Abilitator combines the multidimensional and biopsychosocial models of work ability and functioning. It also includes aspects of social inclusion and employability. It evaluates social, psychological, cognitive and physical functioning, and the ability to cope with everyday life. The content of these concepts was validated by the academic and practical expert panels. The Abilitator's 79 ICF codes covered 57% of the Generic, 77% of the Brief Vocational Rehabilitation, and 8% of the Minimal Environmental ICF Core Sets. When compared with the Work Ability Index (WAI) and the World Health Organization Disability Assessment Schedule (WHODAS 2.0), the direct equivalences of the ICF codes were 36 and 44%, respectively. CONCLUSION: The Abilitator sufficiently comprehensively covers the relevant aspects to enable the assessment of the overall work ability and functioning of the population in a weak labour market position.